Women who have just given birth may be motivated to do anything to avoid getting pregnant again right away.
A contraceptive implant procedure while still in the hospital immediately after giving birth is more cost-effective than delaying insertion to a postpartum visit six to eight weeks later. The implant is placed in the arm and can last for three years.
A new study, published in the journal Obstetrics & Gynecology, compares the costs associated with immediate implant insertion with the costs of unintended pregnancy. Researchers used data from published literature to model what would happen to a hypothetical group of 1,000 women who want the contraceptive implant after a recent birth.
The computer model, referred to as a decision analysis, takes into account all possible outcomes for each step of the process.
Postpartum visits
For every 1,000 women using an implant, immediate contraception is expected to avert 191 unintended pregnancies and save over $1 million in the first year compared with delayed insertion.
Cost savings would increase further for the second and third year after insertion. Immediate insertion is cost effective because more women will get the implant compared to a delayed insertion strategy.
“Women can get pregnant again within four weeks of delivering a baby,” says lead author Aileen Gariepy, assistant professor of obstetrics, gynecology & reproductive sciences at Yale School of Medicine.
“Most women resume sexual activity before their postpartum office visit and therefore will be at risk of pregnancy. And 35 percent of women do not return for a postpartum visit.”
Jumping through hoops
The immediate postpartum period—after delivery but before discharge home—is an ideal opportunity for initiating contraceptives because patients are motivated and timing is convenient.
But most insurance policies don’t provide coverage for contraceptive implant while the mother is still in the hospital.
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“Lack of reimbursement is the most significant barrier to providing this highly effective contraceptive,” Gariepy says. “It’s time to stop making women jump through hoops. Providing immediate postpartum insertion helps women and insurance companies. It’s a win-win strategy for all.
“This is important information for policy makers and insurance companies. Our findings show a strong public health benefit and should aid national organizations advocating for insurance providers to reimburse immediate postpartum insertion.”
Researchers from University of California, Irvine, contributed to the work. The National Center for Advancing Translational Sciences at the National Institutes of Health funded the work.
Source: Yale University
